No name has been more synonymous to Promise than Nancy Dykstra, but she now hands off the reins to new leadership.

Dykstra – who played an integral role in the planning and establishment of Promise and then became its founding executive director in 2008 – announced in July her plans to retire at the end of the year.

As executive director, Dykstra navigated Promise through an arduous four-year campaign to obtain its designation as a Federally Qualified Health Center in 2012. She oversaw the health center’s growth of services from preventative and primary medical and prenatal care to a comprehensive range of core services that now includes dental, vision/eye, family planning behavioral health and outreach assistance. She guided the health center through a continuous expansion of facilities that now encompass all of the available space in Sioux Center’s former bowling alley building, which Promise first leased and now owns.

For her outstanding contributions to Promise and her tireless advocacy to the community health center model of care, Dykstra was awarded the 2017 Carl Kulczyk Memorial Award by the Iowa Primary Care Association on Oct. 17 during its annual conference in Des Moines. Her contributions also were celebrated during Promise’s ninth annual “An Evening of Promise” Celebration and Fundraiser on Nov. 2 and a retirement Christmas party on Dec. 12.

She will leave a legacy of service.

“What is most satisfying to me as I look back on my time as Promise’s executive director is knowing that the center will continue to be here for all those who need access to care – care provided with dignity and compassion, no matter a person’s income level, background or life situation,” Dykstra said. “Working in a health center is about working with people – meeting them where they are and addressing their situation as it is. It’s about building roads out for people who face barriers. A wonderfully rewarding journey.”

To learn more about the positive influence she has had in leading Promise from its humble beginnings to where it it today, read this feature story.

2. NEW EXECUTIVE DIRECTOR ASSUMES ROLE

Nathan Vander Plaats visits withstaff during his first day as PromiseCHC's executive director on Dec. 11.

A new leader was selected to lead Promise into its next chapter: Nathan Vander Plaats.

His selection in November culminated an extensive four-month search process to replace Promise’s founding executive director, Nancy Dykstra. He assumed his role Dec. 11.

Vander Plaats steadily progressed in leadership roles throughout his career.

He served as a caseworker for former U.S. Sen. Tom Harkin in his state offices in Sioux City and later Davenport for six years, 2003-09. He then was promoted to the position of regional director for the senator’s Sioux City office, where he oversaw all operations for the western third of Iowa for three years, 2009-12. Shortly after earning his master’s degree in public administration from Iowa State University of Ames in 2012, Vander Plaats accepted the position of director of mission services for Iowa and Nebraska for Goodwill of the Great Plains. In January 2017, he was promoted to the position of director of retail for Goodwill of the Great Plains, leading 350 retail team members, including 21 store managers and five sales territory managers.

He said one word sums up why he was interested in leading Promise: “People.”

“Thousands of people from all walks of life rely on Promise every year for their health needs, and Promise’s amazing staff is responsible for meeting those health needs,” he said. “When I first interviewed with Promise for this position, I was struck by the authentic care with which they approached their work for those who come to Promise. The board and employees’ passionate care for others is what really attracted me to Promise.”

The deteriorating yellow, steel exterior of Promise’s building is being transformed into a much more inviting and modern look.

Promise’s facelift was made possible thanks the generous donations of many individuals and businesses. Promise launched a $250,000 capital campaign for the exterior renovation project in November 2016. The health center committed to 50 percent of the cost, but it appealed to the greater community to donate the remaining funds – or $125,000 – to make the project a reality. That goal was successfully reached during the early portion of 2017.

All four sides of the building are being renovated with a brick and EIFS finish. A new front doorway and floor-to-ceiling windows were installed on the west side. Promise’s awnings on the west and east sides will be replaced with a modern lighted feature. A new entrance was installed for the Los Palmas Mexican Grocery Store on the north side. Sidewalks were reconstructed to enhance safety.

“Improving the exterior of the building for Promise is an exciting project for many reasons, but most of all, I believe it says to the community that the services and resources of a federally qualified health center are vital to a diversifying and healthy community,” Dykstra said. “I believe our patients, staff and the greater community can take pride in a building that is welcoming and inviting.”

Schelling Construction began construction work on the project in August, and the renovation project now is in its final stages.

Promise CHC filled out the remaining vacantportions of its building when it completedan interior expansion project in the spring.A larger community education/conferenceroom was part of the project.

All of the available spaces in Sioux Center’s former bowling alley are now full.

This spring, Promise completed a 2,200-square-foot expansion and renovation project that filled the remaining vacant spaces of its building.

The interior expansion project included a much larger community education/conference room, two patient rooms and two offices. The vision/eye care program moved into one of the exam rooms, and the second exam room will allow for future growth. The two new offices are occupied by the executive director and chief financial officer.

The project also involved the remodeling and reuse of existing spaces, including the former conference room that has been divided into four office cubicles. The project also opened up an exam room and offices to better facilitate staff and services.

“The expansion and remodel of space at Promise says that we will continue to grow and change – always looking for ways that best meet the needs of those we seek to serve,” Dykstra said.

Promise will be on the front lines of tackling the growing opioid epidemic.

The health center was awarded a $166,130 Access Increases in Mental Health and Substance Abuse Services (AIMS) grant in September from the U.S. Health Resources and Services Administration. The grant will enable Promise to expand its mental health services and add substance abuse services – with a particular focus of addressing people’s addiction to opioids, which are drugs used to reduce pain.

In the process, Promise will hire two full-time professionals – a licensed mental health social worker and a bilingual mental health assistant – and increase its behavioral health services from 11 to 32 hours per week.

Dykstra said the grant will allow Promise to expand its current integrated and team-based model of behavioral health care with primary care. Promise will implement evidence-based screening, assessment, and mental health and substance abuse practices. Promise will enhance collaboration and referral services with local behavioral health providers and community-based organizations.

“Promise CHC will educate the community on the opioid epidemic and provide resources and tools to assist families on seeking help for family members,” Dykstra said. “This is vital to address the growing opioid epidemic in our community and nation.”To learn more, read this story.

THE BEST OF THE REST . . .

To be sure, these stories were just the start of what was another busy year at Promise.

Other top stories included:

A nurse health coach was added as a new position at Promise to interact on a one-on-one basis with patients to help them with chronic conditions. Not long after being hired to the part-time role, Stephanie Van Ruler had a full slate of patients. She now is moving into a full-time role, and nurse Kim Davelaar also will be transitioning into the nurse health coach role to further expand the service.

Roleen Walgenbach was hired in the spring to fill in as a part-time nurse practitioner. In the process, Promise added a new service of offering Department of Transportation medical exams to commercial motor vehicle drivers due to her certification in that area.

Promise expanded its vision/eye care services from one day to two days per week when Dr. Tyler Vermeer of Family Eye Care of Rock Valley began seeing patients in August. He takes appointments 1-5 p.m. Tuesdays, while Dr. Dan Clousing continues to see patients 8 a.m.-noon Wednesdays.

Promise launched its online patient portal, called MyPromiseChart, in September, giving patients access to their personal health information right at their fingertips.

Promise’s midwifery team attended 12 home births in August – a record for one month. Six of the births were in South Dakota and six in Iowa.

Thursday, December 28, 2017

SIOUX CENTER – Heidy Hernandez hopes to make patients feel welcome and feel like they are in the best place they can be when they come into Promise Community Health Center.

As a new receptionist at Promise, she will be one of the first persons they will see.

Heidy Hernandez wants to make patients feelwelcome as they come into Promise CommunityHealth Center. She recently assumed her roleas a receptionist at the health center.

“I love to help people in their needs, and Promise is the best place to do that,” she said.

Heidy, who is bilingual in English and Spanish, grew up in South Sioux City, NE. She attended high school there and now is taking classes at Northwest Iowa College in Sheldon.

She worked at Orange City Health System, 2011-2013; at Rock Industries in Rock Valley, 2013-17; and at Hope Haven for a few months before starting at Promise.

She’s now happy to be at Promise.

“It has been a very good organization by helping the communities around Sioux County,” Heidy said. “Many people have been helped with their needs. That makes Promise one of the places that people want to come back to.”

Promise Community Health Center of Sioux Center is the only Federally Qualified Health Center serving the far northwest corner of Iowa. Promise provides medical, prenatal, dental, vision and behavioral health services. To learn more, visit www.promisechc.org and watch this video. To read more Promise news, visit promisechcnews.blogspot.com.MORE ABOUT HEIDY:Heidy Hernandez and her husband, Raul Olmedo, live in Sheldon and have four children, Ashley, 12; Abigail, 6; Adrian, 5; and Anthony, 2. In her spare time, she loves spending as much time as possible with her family. She also enjoys playing soccer – her favorite sport.

The family of Rodolfo and Luz Murillo of Hawarden drove away from Promise Community Health Center in Sioux Center on Wednesday afternoon with a pickup filled with gifts, thanks to the Christmas-giving spirit of the 20 students, three teachers and parents of Doon Christian School.

“We’re very grateful,” Rodolfo said through an interpreter, with an expression of amazement and gratitude. “We weren’t expecting all this. Thank you very much.”

Mary Leusink, the teacher for grades K-2, said Doon Christian School does a Christmas-giving project every year to show the students that “it is better to give than receive.”

In past years, school personnel easily could think of someone in the Doon area to bless, but they didn’t have anyone in mind this year. So Leusink asked her daughter Kari Ney, a registered nurse for the midwifery team at Promise, if she knew of a family that the school could help out.

The Murillos were one of the families that Ney suggested because they had dealt with various financial and emotional stresses in recent years, including a daughter who had been treated for leukemia. They have four children, Rodolfo, 16; Allisson, 9; Natalie, 7; and Kassandra, 4, and are expecting fifth child next spring.

Doon Christian School students delivered gifts toPromise Community Health Center to donate to afamily from their Christmas-giving project.

“We want to have our students show that the real reason we celebrate Christmas is by the sharing of Christ’s love by blessing those in need,” she said. “We talked about how it could be all of us in their situation, too; how we are blessed beyond what we deserve. As teachers, we shared how God already had this family picked out for our project this year long before we even knew about them.”

The family had a simple Christmas wish.

“The family wanted socks,” Leusink said. “When I told the students during our Friday Devotional Chapel, they were so quiet. Socks?”

They wanted to do more, so they decided to add a pair of pants, a shirt and a sweatshirt for each member of the family – as well as a toy for each of the children.

Pants, shirts and sweatshirts, socks, giftcards and various baby items were donatedto a Hawarden family by Doon ChristianSchool students, teachers and parents.

The day after Thanksgiving break, the items were written on cards and hung on the Christmas tree at the school. Each student took at least one card; some took two. They purchased the items, wrapped them and placed them in a growing pile under the tree.

Parents also got into the giving spirit by donating money that was used to purchase gift cards to Walmart, Fareway and Casey’s. With the family expecting another child, a large variety of baby items – including diapers in various sizes, wipes, sleepers, Onesies and blankets – were donated as well.

The gifts were delivered to Promise and given to the family on Wednesday.

Leusink said the students really embraced the project.

“They were all extremely excited,” she said. “They talked about the family and prayed daily for them. The middle room wrote the children letters. Because of the ages of the children, our students were more than excited this year. They could easily relate to the needs of the family. In fact, the students are already anxious for next year: ‘Can we please do this again?’”

For the semester-long study, the group answered the following clinical question:

“How does the education provided to patients at Promise Community Health Center compare to current evidence-based best practice methods regarding health education?”

“We found that what you are currently doing is meeting evidence-based practices, but all the research that we did just really emphasizes the importance that you can never have too much patient education,” Bosch said, noting that is especially important for the population served at Promise – with patients often speaking other languages and tending to be lower income and having lower levels of formal education.

The student group offered the following recommendations for Promise:

Bethany Los answers questions regarding findings of asemester-long research project that a group ofNorthwestern College nursing students conductedon behalf of Promise Community Health Center.

Develop a survey to distribute at patient appointments to evaluate the effectiveness of current educational methods for the populations being served.

Create an educational checklist, based on the results of the survey, that providers and nurses would use in their care with patients to ensure that they are being intentional about patient education.

During the project, the students discovered on Promise’s website that the health center already is seeking to increase its nurse health coach support. They were pleased to see that because it fit into their research, which emphasized the importance of that resource.

“That availability definitely proves to be very effective,” Bosch said.

The students also said the way health education is delivered is important – noting that patient understanding greatly increases with simplified language.

“With having different cultures served here, different health literacies, we hope the education still is being spread properly and everyone is recalling exactly,” Elliot said. “Whether they speak a different language or they read at a different level, we would hope education is being met so that everytime you’re seeing a patient, they can say, ‘Yes, I totally understand what you’re saying. This is how I have to take care of myself. This is how the doctor told me to take my medication.’”

The students also said testing recall of education is important. That fits with Promise’s practice of using the “Teach Back” method. The method is a way of checking patients’ understanding about what has been explained by asking them to state back in their own words what they need to know or what they need to do. That can range from a front desk receptionist asking a patient to respond with what they should bring to an appointment to a physician asking a patient to share how they should take a medication.

The group of Northwestern College nursing studentswho did a research project regarding patient healtheducation for Promise Community Health Centerconsisted of: Allison Daugherty, Blair Montgomery,Bethany Los, Katie Bosch and Kathryn Elliot.

Overall, the students emphasized that patient health education shouldn’t be underestimated.

“Health education is an essential part of preventing disease and increasing overall health,” Los said.

Emily Tuschen, clinic manager for Promise, said the presentation was beneficial.

“I thoroughly enjoyed listening to their presentation and how they connected the evidence-based research to what is feasible in the day to day of a busy clinic,” she said. “The tools and templates that they handed back to Promise for future use are very applicable to our current processes. I have all intentions of implementing their proposals and following their recommended timeline to fine-tune our current policy regarding patient education.”

Tuschen added that working with the Northwestern seniors over the past few months has been “very enjoyable.”

“It was fun to see these future nurses finishing their college experience and getting ready to transition into the career world,” she said. “They were a very professional group of girls – great communicators and easy to work with.”

Monday, November 27, 2017

SIOUX CENTER – Are you confused about the flurry of changes going on with Iowa’s privately managed Medicaid program?

Are you concerned about how you will be affected because you no longer will be covered by AmeriHealth Caritas of Iowa and have been switched to UnitedHealthcare? Do you wonder if you will be affected as an Amerigroup Iowa member?

Fatima Arteaga and the rest of the outreach staff atPromise Community Health Center in Sioux Centercan help answer questions that people haveregarding changes going with their insurancein Iowa's privately managed Medicaid program.

The outreach staff at Promise Community Health Center in Sioux Center can help you navigate this confusing and complex situation. They can answer questions and help you understand the changes – whether you have been covered by AmeriHealth, Amerigroup or UnitedHealthcare.

The advice and assistance that they provide is free.

“I would encourage people to come to Promise and talk to our outreach department about any concerns they are having with the Medicaid changes,” said Jessica Mora, office manager and outreach coordinator for Promise.

Since April 1, 2016, three private insurance companies have been managing the care of Iowa’s Medicaid patients instead of the state – with the new program called IA Health Link. Since then, all Medicaid patients either were assigned to or chose one of these companies – which are referred to as Managed Care Organizations (MCOs) – for their health insurance coverage.

This system recently unraveled, however, when AmeriHealth announced on Oct. 31 that it planned to withdraw on Dec. 1. That decision affected 213,000 Iowans, including many Promise patients. The Iowa Department of Human Services decided to automatically transfer these Medicaid patients to UnitedHealthcare, unless patients chose the option to switch to Amerigroup instead.

However, the privately managed Medicaid system was further shook up when the DHS announced last week that Amerigroup no longer would accept any new enrollees. This affected both the former AmeriHealth members who had already switched this month to Amerigroup or any new Medicaid enrollees in the future – leaving UnitedHealthcare as the only managed-care choice for those Medicaid members. Amerigroup will continue to serve the members it was covering prior to Nov. 1, so their Medicaid insurance will not be affected for now.

Promise has had agreements in place with all three managed-care companies, so all Medicaid patients will continue to have insurance coverage for services provided at the health center – whether they are members of UnitedHealthcare or Amerigroup. However, patients who are referred to specialists or other health-care facilities in the region may be affected if UnitedHealthcare does not have agreements with those providers.

“The concern for payment coverage when patients need care from specialists concerns us,” said Nancy Dykstra, executive director of Promise. “Our patients and our communities are located near South Dakota, Minnesota and Nebraska, and we have experienced scenarios where specialists in outlying areas do not have agreements with Iowa’s Medicaid managed-care companies. Changes like this to Iowa’s Medicaid system have a significant impact on many of our most vulnerable citizens.”

Promise’s outreach staff will help the patients who have been switched to Unitedhealthcare better understand their insurance coverage and where they can go for covered services. In other words, they can help patients find providers that are “in network” with Unitedhealthcare.

The state has indicated that it will begin to work on securing new managed-care companies so that choice can be offered again to Medicaid patients, but that is expected to take months.